Provider Demographics
NPI:1083831226
Name:COLE, JOHN B (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:B
Last Name:COLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3317 TAYLOR BLVD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40215-2632
Mailing Address - Country:US
Mailing Address - Phone:502-632-2333
Mailing Address - Fax:502-749-3992
Practice Address - Street 1:3317 TAYLOR BLVD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40215-2632
Practice Address - Country:US
Practice Address - Phone:502-632-2333
Practice Address - Fax:502-749-3992
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYCH4440111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYCH4440OtherCHIROPRACTOR
KYCH4440OtherCHIROPRACTOR